Search results for ‘Subject term:"older people"’ Sort:
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A systematic review of older adults’ request for or attitude toward euthanasia or assisted-suicide
- Authors:
- DRANSART Dolores Angela Castelli, et al
- Journal article citation:
- Aging and Mental Health, 25(3), 2021, pp.420-430.
- Publisher:
- Taylor and Francis
Objectives: Prevalence rates of death by euthanasia (EUT) and physician-assisted suicide (PAS) have increased among older adults, and public debates on these practices are still taking place. In this context, it seemed important to conduct a systematic review of the predictors (demographic, physical health, psychological, social, quality of life, religious, or existential) associated with attitudes toward, wishes and requests for, as well as death by EUT/PAS among individuals aged 60 years and over. Method: The search for quantitative studies in PsycINFO and MEDLINE databases was conducted three times from February 2016 until April 2018. Articles of probable relevance (n = 327) were assessed for eligibility. Studies that only presented descriptive data (n = 306) were excluded. Results: This review identified 21 studies with predictive analyses, but in only 4 did older adults face actual end-of-life decisions. Most studies (17) investigated attitudes toward EUT/PAS (9 through hypothetical scenarios). Younger age, lower religiosity, higher education, and higher socio-economic status were the most consistent predictors of endorsement of EUT/PAS. Findings were heterogeneous with regard to physical health, psychological, and social factors. Findings were difficult to compare across studies because of the variety of sample characteristics and outcomes measures. Conclusion: Future studies should adopt common and explicit definitions of EUT/PAS, as well as research designs (e.g. mixed longitudinal) that allow for better consideration of personal, social, and cultural factors, and their interplay, on EUT/PAS decisions. (Edited publisher abstract)
Advance Decisions: issues of autonomy, identity and efficacy
- Author:
- WILKINSON Sue
- Journal article citation:
- Working with Older People, 21(1), 2017, pp.4-12.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to introduce Advance Decisions, address low uptake and examine fundamental issues that can inform the development of policy and practice in this area. Design/methodology/approach: This paper discusses findings from a research project with the charity Compassion in Dying (analysing calls to its telephone helpline) and practical experience of working with the charity Advance Decisions Assistance (helping people write Advance Decisions and training healthcare professionals). Findings: Older people themselves identify the issues of autonomy, identity and efficacy as key challenges in writing Advance Decisions and having them respected. Originality/value: This paper shows how addressing the “real world” challenges of advance decision making can inform policy and practice. (Publisher abstract)
A survey of older peoples’ attitudes towards advance care planning
- Authors:
- MUSA Irfana, et al
- Journal article citation:
- Age and Ageing, 44(3), 2015, pp.371-376.
- Publisher:
- Oxford University Press
Background: Advance care planning (ACP) is a process to establish an individual's preference for care in the future; few UK studies have been conducted to ascertain public attitudes towards ACP. Objective: The aim of this study was to assess the attitudes of older people in East Midlands through the development and administration of a survey. Design: The survey questionnaire was developed on the basis of a literature review, exploratory focus groups with older adults and expert advisor input. The final questions were then re-tested with lay volunteers. Setting: Thirteen general practices were enrolled to send out surveys to potential participants aged 65 or older. There were no additional inclusion or exclusion criteria for participants. Methods: Simple descriptive statistics were used to describe the responses and regression analyses were used to evaluate which items predicted responses to key outcomes. Results: Of the 5,375 (34%) community-dwelling older peoples, 1,823 returned questionnaires. Seventeen per cent of respondents had prepared an ACP document; of whom, 4% had completed an Advance Decision to Refuse Treatment (ADRT). Five per cent of respondents stated that they had been offered an opportunity to talk about ACP. Predictors of completing an ACP document included: being offered the opportunity to discuss ACP, older age, better physical function and male gender. Levels of trust were higher for families than for professionals. One-third of the respondents would be interested in talking about ACP if sessions were available. Conclusion: Although a third of the respondents were in favour of discussing ACP if the opportunity was available with their GP, only a relative minority (17%) had actively engaged. Preferences were for informal discussions with family rather than professionals. (Edited publisher abstract)
Older people's conceptualization of abuse: a systematic review
- Authors:
- KILLICK Campbell, et al
- Journal article citation:
- Journal of Elder Abuse and Neglect, 27(2), 2015, pp.100-120.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This systematic literature review aims to identify and synthesize empirical research findings relating to older people’s conceptualization of abuse. In so doing, it attempts to answer four key questions: does the term 'abuse' have meaning for older people?; how do older people understand the concept of abuse?; are such understandings similar across populations and locations?; and how do older people’s conceptualizations of abuse compare with those of other groups, including carers and professionals? A total of eight databases were searched using agreed-upon criteria, and the results were assessed for relevance. These were Ageinfo, Applied Social Sciences Index and Abstracts (ASSIA), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google Scholar, Medline, Psychinfo, Social Care Online, Social Services Abstracts (SSA), and Social Sciences Citation Index (SSCI). Fifteen studies were included, the majority of which were based in America (n = 7) or Canada (n = 4). The findings are discussed under the themes of caregiving, domestic violence, society, abusive acts, and thresholds. The impact of ageing and disempowerment was also a major theme in the studies, and highlights the importance of empowering the individual within any protection process. (Edited publisher abstract)
Effects of age expectations on oncology social workers’ clinical judgment
- Authors:
- CONLON Annemarie, CHOI Namkee G.
- Journal article citation:
- Research on Social Work Practice, 24(4), 2014, pp.477-490.
- Publisher:
- Sage
Objective: This study examined the influence of oncology social workers’ expectations regarding aging (ERA) and ERA with cancer (ERAC) on their clinical judgment. Methods: Oncology social workers (N = 322) were randomly assigned to one of four vignettes describing a patient with lung cancer. The vignettes were identical except for the patent’s age and gender. Structural equation modeling served as the primary tool for testing the study hypotheses. Results: Significant differences were found in clinical judgment based on patient’s age, and social workers’ ERA and ERAC which affected diagnostic and treatment judgment for all patients. Lack of congruence was also found between the diagnosis and treatment phases of care for older patients. Emotional reaction was more often reported for the younger patient. Conclusion: Results suggest a barrier to “whole patient” care for all cancer patients and a need for student and practitioner training to place greater emphasis on the treatment phase of patient care. (Publisher abstract)
Older adult and family member perspectives of the decision-making process involved in moving to assisted living
- Authors:
- KOENIG Terry L., et al
- Journal article citation:
- Qualitative Social Work, 13(3), 2014, pp.335-350.
- Publisher:
- Sage
The decision to move into assisted living (AL) can be viewed as a life-changing process for older adults and their families; and each may possess differing views of this process. This qualitative study examined the AL decision-making process as described by twenty-two older adult and family member dyads. Participants described emotional and logistical components related to the AL moving decision. Further, fifteen of twenty-two dyads expressed conflicting or differing views of the AL moving decision. Our discussion examines the need for future studies to explore the impact of family and older adult disagreements on the older adult’s AL adjustment; the necessity for community-based agencies and AL settings to provide social services over the duration of the decision-making process; and the importance of employing social workers skilled in family practice in the AL setting. (Publisher abstract)
Self-determination among frail older persons: a desirable goal older persons’ conceptions of self-determination
- Authors:
- MARTENSSON Lena, EKLUND Kajsa
- Journal article citation:
- Quality in Ageing and Older Adults, 15(2), 2014, pp.90-101.
- Publisher:
- Emerald
Purpose: Self-determination is governed by ethical and legal rights in western society. In spite of that, older people are still restricted by others in their decision-making processes. The purpose of this paper is to explore older persons’ different conceptions of self-determination. Design/methodology/approach: A qualitative phenomenographic interview study on frail older persons (n=15). Findings: Three categories emerged, showing the variations of conception of self-determination as experienced by frail older people: first, self-determination changes throughout life; second, self-determination is being an agent in one's own life; and third, self-determination is conditional. In summary, while self-determination is changeable throughout life, and older persons want to be their own agents, and struggle to be that, certain conditions must be met to make it possible for them to be able to exercise self-determination. Practical implications: Suggestions for supporting and strengthening frail older persons’ self-determination, and indirectly their well-being and health: to have a person-centered approach, treat them with dignity and respect and give them opportunities to influence and to feel involved; to improve their health literacy by, for example, supporting them with enough knowledge to be able to exercise self-determination; to make them feel safe and secure in relationships, such as with family and caregivers. Originality/value: This study explores frail older persons’ own conceptions of self-determination to be able to gain knowledge of how professionals can support them so that they may experience self-determination in life
The impact of patient age on clinical decision-making in oncology
- Author:
- GREAT BRITAIN. Department of Health
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2012
- Pagination:
- 44p.
- Place of publication:
- London
Providing all patients with high quality, timely treatment is a vital part of improving cancer outcomes. However, there are concerns that there may be under treatment of older people. This report sets out the results of a study investigating the extent to which age is a factor in oncology treatment decisions. A total of 301 oncologists and haematologists covering 6 countries and 5 different types of cancer were surveyed using a 30 minute online questionnaire. The questionnaire included 2 different approaches in which the clinicians were: shown a series of scenarios and asked to select treatment options; and asked a series of questions about what they thought would influence their treatment decisions. The study found a high level of consistency in the clinical attitudes observed in England and other countries. Clinicians do feel that age is an important factor to consider in patient decision-making alongside issues such as number and severity of comorbidities, and stage of cancer. Although the findings from the questions on clinical attitudes suggest that the major factor is the patient’s ability to tolerate the treatment side effects, the findings from the patient scenarios suggest that chronological age is a significant factor in determining the intensity of treatment. The report concludes that age may be used as a proxy for other factors in making recommendations on treatment and that this may lead to some patients receiving less intensive treatment, solely on the basis of their chronological age.
‘I live for today’: a qualitative study investigating older people’s attitudes to advance planning
- Authors:
- SAMSI Kritika, MANTHORPE Jill
- Journal article citation:
- Health and Social Care in the Community, 19(1), January 2011, pp.52-59.
- Publisher:
- Wiley
The Mental Capacity Act 2005 (MCA) enables adults with capacity to make plans and decisions in advance. It allows them to arrange proxy decision-making and provides safeguards for those who might lose the capacity to make decisions in the future. This paper investigated the attitudes of 37 healthy older people about their views on documenting their decision-making preferences. Results indicated that most individuals had a personal preference towards planning, guided by personality, beliefs, living situation and the relevancy of planning to their situation. Financial plans and funeral arrangements were most common; health and social care plans least common. Housing and residential care were important for all. However, few participants had heard of the MCA. The family doctor was cited as trustworthy and a potential place to begin inquiries. Considering the onset of certain debilitating conditions encouraged participants to think about planning. The authors conclude that the study has implications for education campaigns that could potentially impact on older people who are interested in making plans but are unaware that legal safeguards and practical support are available.
A place called LIFE: exploring the advance care planning of African-American PACE enrollees
- Authors:
- BATH Sara B., et al
- Journal article citation:
- Social Work in Health Care, 47(3), 2008, pp.277-292.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Medical records and semi-structured interviews were used to gather data on 18 African-American participants in a PACE (Program of All-Inclusive Care for the Elderly) programme. The aim was to compare their verbalised preferences for end-of-life care with those documented in their records, and to explore the personal values that inform end-of-life decision making. The findings show that most preferred life-sustaining treatments and had limited information on, or understanding of, the interventions and terminology associated with advance directives. End-of-life decision making was influenced by the desire to maintain life as usual, avoid burdening carers, and keep control of personal health care. God was seen as the ultimate arbiter of the end of life, and central to medical decision making. The implications for social work research and practice in relation to advance care planning are discussed.